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Implantation of non-biologic or synthetic implant (eg, polypropylene) for fascial reinforcement of the abdominal wall (List separately in addition to code for primary procedure)

CPT4 code

Implantation of Non-Biologic or Synthetic Implant for Fascial Reinforcement of the Abdominal Wall

Name of the Procedure:

Implantation of non-biologic or synthetic implant (e.g., polypropylene) for fascial reinforcement of the abdominal wall.

Summary

This procedure involves inserting a synthetic mesh or implant to reinforce the abdominal wall, typically after surgery for hernia repair or other abdominal surgeries. The implant helps strengthen the tissue and provides additional support.

Purpose

This procedure addresses weakened or damaged fascia, the connective tissue in the abdominal wall. It aims to provide structural support, reduce the risk of hernia recurrence, and enhance the overall strength of the abdominal wall.

Indications

  • Recurrent hernias
  • Large or complex hernias
  • Abdominal wall defects
  • Patients with weakened abdominal fascia due to previous surgeries or medical conditions

Preparation

  • Fasting for 8 hours before the procedure
  • Stopping certain medications as advised by the doctor
  • Preoperative assessment including blood tests, imaging, and physical examination

Procedure Description

  1. Anesthesia: General anesthesia is typically administered.
  2. Incision: A surgical incision is made in the abdomen.
  3. Placement: The synthetic implant or mesh is positioned over the weakened area of the abdominal wall.
  4. Securing the Mesh: The implant is secured using sutures, staples, or tacks.
  5. Closure: The incision is closed with sutures or staples, and a sterile dressing is applied.

Duration

The procedure typically takes 1 to 2 hours.

Setting

The procedure is performed in a hospital or surgical center.

Personnel

  • Surgeon
  • Surgical nurse
  • Anesthesiologist
  • Operating room technicians

Risks and Complications

  • Infection
  • Bleeding
  • Mesh migration or rejection
  • Chronic pain
  • Recurrence of hernia

Benefits

  • Reinforced abdominal wall
  • Reduced risk of hernia recurrence
  • Enhanced abdominal strength and function
  • Benefits can typically be realized within a few weeks post-surgery

Recovery

  • Pain management with prescribed medications
  • Limited physical activity for a few weeks
  • Follow-up appointments for wound care and recovery monitoring
  • Possible restrictions on lifting and strenuous activities for 4-6 weeks

Alternatives

  • Suture repair without mesh
  • Biologic implants for patients with allergic reactions to synthetic materials
  • Watchful waiting in cases of small, asymptomatic hernias

Patient Experience

Patients might feel discomfort or pain post-surgery, which can be managed with medications. There may be a feeling of tightness or pulling in the abdominal area as the tissues heal. Regular follow-ups and adherence to post-operative instructions are crucial for a smooth recovery.

Medical Policies and Guidelines for Implantation of non-biologic or synthetic implant (eg, polypropylene) for fascial reinforcement of the abdominal wall (List separately in addition to code for primary procedure)

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